The medico-legal investigation of abandoned fetuses and newborns—a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa

Abstract:

There is a dearth of literature on the extent of fetal or newborn abandonment or “dumping” and the
medico-legal investigation procedures these cases require. This is despite the fact that these
occurrences are a world-wide phenomenon and by definition involve criminal law concerns such as
illegal abortion, concealment of birth, murder, or neonaticide, depending on the country concerned.
This article contributes to current literature in both respects and provides a retrospective case audit for
the period 2004-2008 pertaining to all abandoned newborns and fetuses admitted to the Pretoria
Medico-Legal Laboratory (PMLL) in South Africa. Demographic details, scope and nature of the
medico-legal investigation as well as formulation of cause of death, were recorded. A total of 289 cases
were identified for inclusion in this study, 57% of which were considered to have been non-viable
fetuses, whilst 45 of the viable fetuses were deemed to have been stillborn. These instances involve the
crimes of concealment of birth and at times illegal abortion, yet prosecution of these cases are
relatively unheard of. Signs of live birth were identified in 38 of the cases in the study. Of these infants,
9 were deemed to have died from injuries they have sustained and in a further 9 cases no anatomical
cause of death could be identified. Homicidal cases should be brought in cases where death ensued as a
result of abandonment however it is not known how many cases were prosecuted. A comparatively
large number of cases were found to have been admitted to the Pretoria Medico-Legal Laboratory. This
is alarming because South African abortion laws are liberal and services are free at point of access in
the public health care sector. A substantial percentage of cases of abandoned infants were found to
have shown signs of life after birth implying a homicidal manner of death or death by abandonment but
it seems these cases are merely shelved.